{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,11]],"date-time":"2026-11-11T00:59:07Z","timestamp":1794358747909,"version":"4.9.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T00:00:00Z","timestamp":1721433600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Center for International Reproductive Health Training"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Pregnancy Childbirth"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The Robson Ten Groups Classification System (RTGCS) is increasingly used to assess, monitor, and compare caesarean section (CS) rates within and between healthcare facilities. We evaluated the major contributing groups to the CS rate at Gulu Regional Referral Hospital (GRRH) in Northern Uganda using the RTGCS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of all deliveries from June 2019 through July 2020 at GRRH, Gulu city, Uganda. We reviewed files of mothers and collected data on sociodemographic and obstetric variables. The outcome variables were Robson Ten Groups (1\u201310) based on parity, gestational age, foetal presentation, number of foetuses, the onset of labour, parity and lie, and history of CS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We reviewed medical records of 3,183 deliveries, with a mean age of 24.6\u2009\u00b1\u20095.7 years. The overall CS rate was 13.4% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009427). Most participants were in RTGCS groups 3 (43.3%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009185) and 1 (29.2%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200988). The most common indication for CS was prolonged labour (41.0%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009175), followed by foetal distress (19.9%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200985) and contracted pelvis (13.6%,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200958).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study showed that GRRH patients had a low-risk obstetric population dominated by mothers in groups 3 and 1, which could explain the low overall CS rate of 13.4%. However, the rates of CS among low-risk populations are alarmingly high, and this is likely to cause an increase in CS rates in the future. We recommend group-specific interventions through CS auditing to lower group-specific CS rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12884-024-06689-4","type":"journal-article","created":{"date-parts":[[2024,7,20]],"date-time":"2024-07-20T03:01:53Z","timestamp":1721444513000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Caesarean section rates in a tertiary teaching hospital in northern Uganda: a retrospective analysis using the robson ten group classification system"],"prefix":"10.1186","volume":"24","author":[{"given":"Eric","family":"Ssennuni","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvis","family":"Akuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kizito","family":"Lukujja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry","family":"Kule","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keneth","family":"Opiro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Awor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baifa","family":"Arwinyo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sande","family":"Ojara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jimmyy","family":"Opee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayikoru","family":"Jackline","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akello","family":"Jackline","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pebalo Francis","family":"Pebolo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,7,20]]},"reference":[{"issue":"10155","key":"6689_CR1","doi-asserted-by":"publisher","first-page":"1341","DOI":"10.1016\/S0140-6736(18)31928-7","volume":"392","author":"T Boerma","year":"2018","unstructured":"Boerma T, Ronsmans C, Melesse DY, Barros AJD, Barros FC, Juan L, Moller A-B, Say L, Hosseinpoor AR, Yi M, et al. Global epidemiology of use of and disparities in caesarean sections. Lancet. 2018;392(10155):1341\u20138.","journal-title":"Lancet"},{"issue":"6","key":"6689_CR2","doi-asserted-by":"publisher","first-page":"e005671","DOI":"10.1136\/bmjgh-2021-005671","volume":"6","author":"AP Betran","year":"2021","unstructured":"Betran AP, Ye J, Moller A-B, Souza JP, Zhang J. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021;6(6):e005671.","journal-title":"BMJ Global Health"},{"issue":"6","key":"6689_CR3","doi-asserted-by":"publisher","first-page":"e005671","DOI":"10.1136\/bmjgh-2021-005671","volume":"6","author":"B Ana Pilar","year":"2021","unstructured":"Ana Pilar B, Jiangfeng Y, Ann-Beth M, Jo\u00e3o Paulo S, Jun Z. Trends and projections of caesarean section rates: global and regional estimates. BMJ Global Health. 2021;6(6):e005671.","journal-title":"BMJ Global Health"},{"key":"6689_CR4","unstructured":"World Health O. Robson classification: implementation manual. 2017."},{"key":"6689_CR5","unstructured":"WHO. WHO Statement on Caesarean Section Rates. 2015."},{"key":"6689_CR6","unstructured":"WHO LGJ, Jeremy A, Lauer, Ana P. Betr\u00e1n,Mario Merialdi and Fernando Althabe:: The Global Numbers and Costs of Additionally Needed and Unnecessary Caesarean Sections Performed per Year: Overuse as a Barrier to Universal Coverage. 2010."},{"issue":"1","key":"6689_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1741-7015-8-71","volume":"8","author":"JP Souza","year":"2010","unstructured":"Souza JP, G\u00fclmezoglu A, Lumbiganon P, Laopaiboon M, Carroli G, Fawole B, Ruyan P. Caesarean section without medical indications is associated with an increased risk of adverse short-term maternal outcomes: the 2004\u20132008 WHO Global Survey on maternal and Perinatal Health. 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Uganda Demographic Health Surveys In.; 2016."},{"key":"6689_CR15","unstructured":"Uganda RO. ANNUAL HEALTH SECTOR PERFROMANCE REPORT 2018\u20132019. In. Edited by Health Mo: Minsitry of Health; 2019."},{"key":"6689_CR16","doi-asserted-by":"crossref","unstructured":"Nantume S, Baluku EM. Factors Associated with high rates of caesarean deliveries: A Cross Sectional Study classifying deliveries according to Robson in Mengo Hospital Kampala. 2023, 16:2339\u201356.","DOI":"10.2147\/RMHP.S422705"},{"key":"6689_CR17","unstructured":"Ministry of Health U. Essential Maternal and Neonatal Clinical Care Guidelines. 2022."},{"key":"6689_CR18","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12884-020-03474-x","volume":"20","author":"FA Abubeker","year":"2020","unstructured":"Abubeker FA, Gashawbeza B, Gebre TM, Wondafrash M, Teklu AM, Degu D, Bekele D. 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Since it was a retrospective review of records in the hospital, GUREC waived the consent to participate. Confidentiality was maintained, and all mothers\u2019 names and other personal identifiers were not captured in the data collection tool and were not included in the final report.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and Consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"489"}}